Provider Demographics
NPI:1508976176
Name:BEAL PHYSICAL THERAPY P L
Entity Type:Organization
Organization Name:BEAL PHYSICAL THERAPY P L
Other - Org Name:BEST IN TOWN PHYSICAL THERAPY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:JENNIFER
Authorized Official - Middle Name:GWEN
Authorized Official - Last Name:BEAL
Authorized Official - Suffix:
Authorized Official - Credentials:DPT
Authorized Official - Phone:561-688-1844
Mailing Address - Street 1:500 NORTHPOINT PKWY STE 200
Mailing Address - Street 2:
Mailing Address - City:WEST PALM BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33407-1903
Mailing Address - Country:US
Mailing Address - Phone:561-688-1844
Mailing Address - Fax:561-688-1845
Practice Address - Street 1:500 NORTHPOINT PKWY STE 200
Practice Address - Street 2:
Practice Address - City:WEST PALM BEACH
Practice Address - State:FL
Practice Address - Zip Code:33407-1903
Practice Address - Country:US
Practice Address - Phone:561-688-1844
Practice Address - Fax:561-688-1845
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-30
Last Update Date:2018-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPT 4764225100000X, 225100000X
FLOT 10916225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Multi-Specialty
No225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLK6768Medicare ID - Type Unspecified